Table 2

Core and context-specific indicators for monitoring routine ANC

Core indicators
Monitoring domainIndicatorCurrent preferred data sourceOther data sourcesWHO ANC model
OutputsPercentage of pregnant women with first ANC contact in the first trimester (before 12 weeks of gestation)Population-based surveysHMISRecommendation E.7*
OutcomesPercentage of pregnant women who received iron and folic acid supplements for 90+ daysPopulation-based surveysHMISRecommendations A.2.1 and A2.2*
Percentage of pregnant women screened for syphilis during ANCHMIS Recommendations B.1.7* and 4.1†
 ANC contacts:

  1.  Percentage of pregnant women with at least four ANC contacts.

  2.  Percentage of pregnant women with a minimum of eight ANC contacts.

Population-based surveys Recommendation E.7*
Percentage of pregnant women who were told about pregnancy danger signs during ANCPopulation-based surveys Recommendation 1‡
 Blood pressure measurement:

  1.  Percentage of pregnant women with at least one blood pressure measure during ANC.

  2.  Percentage of pregnant women with at least one blood pressure measure in the third trimester during ANC.

 Population-based surveys (indicator A)
 HMIS (indicator B)		 HMIS (indicator A)Good clinical practice
Percentage of pregnant women whose baby’s heartbeat was listened to at least once during ANCPopulation-based surveysHMISGood clinical practice
Percentage of pregnant women with an ultrasound scan before 24 weeks§HMIS Recommendation B.2.4*
Experience of care (eg, waiting time and support received during ANC contacts)§Population-based surveysResearch and health facility surveysGood clinical practice
Context-specific indicators
Monitoring domainIndicatorMonitoring contextCurrent preferred data sourceOther data sourcesWHO ANC model
InputsHealth worker density and distributionRural and remote areasCivil registration and vital statisticsHMIS, health facility surveys and annual administrative reportsRecommendation E.6*
ProcessPercentage of health units with at least one service provider trained to care for and refer survivors of gender-based violenceSettings where there is the capacity to provide a supportive response (including referral where appropriate) and that meet the WHO minimum requirements for responding to intimate partner violence and sexual violence against womenHealth facility assessments Recommendation B.1.3*
OutcomesPercentage of pregnant women counselled and tested for HIVHigh-prevalence settingsPopulation-based surveysHMISRecommendation B.1.7*
Percentage of pregnant women reporting having received any drug for intestinal wormsHelminth-endemic areasPopulation-based surveys Recommendation C.4*
Percentage of women who received three or more doses of IPTpMalaria-endemic areas in AfricaPopulation-based surveysHMISRecommendation C.6*
Percentage of PrEPPregnant women at substantial risk of HIV infectionPopulation-based surveysHMISRecommendation C.7*

  • *Recommended by WHO.1

  • †Recommended by WHO.8

  • ‡Recommended by WHO.6

  • §Placeholder for recommended indicator that may be updated in the future once additional research is conducted.

  • ANC, antenatal care; HMIS, health management information systems; IPTp, intermittent preventive treatment in pregnancy; PrEP, pregnant women who received oral pre-exposure prophylaxis.